Clinical Examination and Single-phase Contrast-enhanced CT Scans to Distinguish Benign Lesions from Malignant Tumors of the Parotid Gland

Chakri  Madla; Salita  Angkurawaranon; Hanpon  Klibngern; Sayanan  Chowsilpa

Authors

Chakri Madla Department of Radiology, Faculty of Medicine, Chiang Mai University, Thailand https://orcid.org/0000-0002-3435-6369
Salita Angkurawaranon Department of Radiology, Faculty of Medicine, Chiang Mai University, Thailand https://orcid.org/0000-0001-6211-5717
Hanpon Klibngern Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Thailand https://orcid.org/0000-0002-2468-4772
Sayanan Chowsilpa Department of Pathology, Faculty of Medicine, Chiang Mai University, Thailand https://orcid.org/0000-0001-9708-4949

Keywords:

parotid gland, computed tomography, pleomorphic adenoma, mucoepidermoid carcinoma

Abstract

Objective To distinguish between benign lesions and malignant tumors of the parotid gland through physical examination and analysis of single-phase contrast-enhanced CT imaging.

Methods A retrospective study of parotid gland masses in adult patients (age > 15 years) at Maharaj Nakorn Chiang Mai Hospital from 2014 to 2021. Patient demographic data included gender, age and smoking history. Characteristics of parotid masses were established based on physical examinations including mass consistency, pain/tenderness, invasion of surrounding tissue including fixation, skin involvement, trismus and facial nerve palsy, as well as imaging findings indicating mass location, size, number, distribution, shape, margin, composition, extra-parenchymal extension and calcification.

Results A total of 78 patients (10 exhibiting bilateral parotid gland involvement) were diagnosed with a total of 44 benign lesions and 34 malignant tumors. Significant parameters for suspicion of malignancy were determined by two clinical examinations, hard consistency (odds ratio = 60.00, 95% CI = 4.72 to 763.01) and pain/tenderness (odds ratio = 7.45, 95% CI = 1.90 to 29.25) and four imaging findings composed of irregular shape (OR = 7.00, 95% CI = 1.69 to 28.92), ill-defined margins (OR = 10.15, 95% CI = 3.28 to 31.44), extra-parenchymal extension (OR = 32.50, 95% CI = 8.88 to 118.99) and calcification (OR = 6.97, 95% CI = 1.74 to 27.88).

Conclusions Clinical examination and findings obtained from single-phase contrast-enhanced CT scans can help to distinguish benign from malignant parotid masses.

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